title: Proposed treatment protocol for frostbite: a retrospective analysis of 17 cases based on a 3-year single-institution experience.
abstract: BACKGROUND
  This paper discusses the treatment protocol for patients with frostbite.
  
  
  METHODS
  We performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012.
  
  
  RESULTS
  Our clinical series of patients (n=17) included 13 men and four women, whose mean age was 42.4±11.6 years (range, 22-67 years). The sites of injury include the foot in six patients (35.3%), the hand in six patients (35.3%) and the facial region in five patients (29.4%). Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of 12.7±3.3 days (range, 8-16 days). Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of 35±4.3 days (range, 29-39 days). Five patients with fourth-degree frostbite were treated with surgical procedures including amputation.
  
  
  CONCLUSIONS
  With the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hallym University Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Eun-Kyung
authors.initials: EK
authors.lastname: Woo
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Lee
authors.forename: Gi-Yeun
authors.initials: GY
authors.lastname: Hur
authors.forename: Jang-Hyu
authors.initials: JH
authors.lastname: Koh
authors.forename: Dong-Kook
authors.initials: DK
authors.lastname: Seo
authors.forename: Jai-Ku
authors.initials: JK
authors.lastname: Choi
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Jang
keywords: Frostbite; Operative surgical procedure; Therapy